Τίτλος:
Bloodstream infections by gram-negative bacteria in kidney transplant patients: Incidence, risk factors, and outcome
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Kidney transplant recipients (KTRs) are at increased risk of infections. Methods: The aims of this study were to describe the incidence of bloodstream infections (BSIs) by gram-negative bacteria in a cohort of KTRs, the risk factors for BSI due to multi-drug–resistant (MDR) gram-negative bacteria, and the predictors for unfavorable outcome, defined as death or nephrectomy or return to dialysis, within 30 days from BSI. We conducted a retrospective cohort study at the renal transplant unit of a tertiary care hospital in Athens, Greece. Results: In a total of 1962 KTRs, we recorded 195 BSI episodes in 182 single patients (male/female = 97/85), with a median (interquartile range) age of 57.2 (44-64.9) years. The incidence was 1.393/100 patient-years. The most common source of infection was urinary tract (70.9%), and Escherichia coli (63.7%) was the most common pathogen. 19.2% of the infecting organisms were MDR; previous antibiotic use (OR 8.2; CI 2.1-32.9) and previous stay in the intensive care unit (OR 34.2; CI 1.6-730.2) were associated with MDR BSIs. 6% of patients died, and 2.2% underwent nephrectomy, while no patients had to return to dialysis. Diabetes mellitus (OR 8.1; 95% CI 1.3-50.3), Pseudomonas aeruginosa BSI (OR 46.1; 95% CI 3.9-552.3), and septic shock (OR 46.7; 95% CI 1.7-1304.9) were independent predictors of unfavorable outcome. Conclusion: Bloodstream infections in KTRs have a significant impact on allograft and patients outcome. © 2020 Wiley Periodicals LLC
Συγγραφείς:
Tsikala-Vafea, M.
Basoulis, D.
Pavlopoulou, I.
Darema, M.
Deliolanis, J.
Daikos, G.L.
Boletis, J.
Psichogiou, M.
Περιοδικό:
Transplant Infectious Disease
Εκδότης:
Blackwell Publishing Inc.
Λέξεις-κλειδιά:
amikacin; antibiotic agent; carbapenemase; cefotaxime; ceftazidime; cephalosporin derivative; ciprofloxacin; clavulanic acid; corticosteroid; cyclosporine; hypertensive agent; imipenem; immunosuppressive agent; infusion fluid; mammalian target of rapamycin inhibitor; meropenem; metallo beta lactamase; mycophenolate mofetil; netilmicin; piperacillin; piperacillin plus tazobactam; proton pump inhibitor; tacrolimus; tigecycline, adult; aged; antibiotic resistance; antibiotic sensitivity; antibiotic therapy; Article; bloodstream infection; cohort analysis; controlled study; death; diabetes mellitus; dialysis; Escherichia coli infection; female; Gram negative infection; Greece; human; immunosuppressive treatment; incidence; infection risk; kidney transplantation; major clinical study; male; middle aged; multidrug resistance; nephrectomy; nonhuman; postoperative infection; priority journal; Pseudomonas aeruginosa; Pseudomonas infection; retrospective study; risk factor; septic shock; urinary tract infection; bacteremia; graft recipient; Gram negative bacterium; Gram negative infection; sepsis, Bacteremia; Female; Gram-Negative Bacteria; Gram-Negative Bacterial Infections; Greece; Humans; Incidence; Kidney Transplantation; Male; Middle Aged; Retrospective Studies; Risk Factors; Sepsis; Transplant Recipients
